AB0233 CARDIOVASCULAR EVENTS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A TWO YEARS OBSERVATIONAL STUDY.
Authors: P. Martinez Calabuig, R. González Mazarío, J. J. Fragío Gil, E. Grau García, C. Pávez Perales, S. Leal Rodriguez, C. Riesco Barcena, A. V. Huaylla Quispe, L. Mas Sanchez, P. Muñoz Martinez, J. E. Oller Rodríguez, E. Vicens Bernabeu, R. Negueroles Albuixech, J. Ivorra Cortés, F. Ortiz-Sanjuán, M. De la Rubia Navarro, L. Gonzalez Puig, I. Martínez Cordellat, C. Nájera Herranz, I. Cánovas Olmos, J. A. Román Ivorra
Journal: Annals of the Rheumatic Diseases (2022)

Background The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is higher than individuals from the general population due to chronic inflammation. Current CV risk screening and management strategies underestimate the actual CV risk in RA. Thus, an adequate CV risk stratification has special relevance in RA to identify patients at risk of CV disease. Objectives To assess the incidence of cardiovascular events in a RA cohort after a 2 years follow-up. Methods A cohort study was performed in which inclusion criteria were adult RA patients and matched adults in terms of age, sex and CV risk factors (controls). Population over 75 years old, patients with established CV disease and/or stage III chronic kidney disease were excluded. Controls with other inflammatory diseases, pregnant women or any malignancy were also excluded. This study was performed from July-2019 to January-2022. CV risk assessment included risk factors collection and US evaluation consisted in detection of plaques and measurement of the intima-media thickness in both right and left carotid. Results Overall, a total of 200 cases and 111 healthy controls were enrolled in the study. Demographical and clinical variables were comparable between cases and controls and are shown in Table 1. US study revealed a higher IMT in both right and left carotid arteries with greater presence of plaques in patients than in controls (CI 95% [1.542; 3.436], p&lt;0.001). Plaques were found in both carotid arteries in the 32% of cases and 9.91% of controls. The longer duration of RA was related to a higher presence of carotid plaques (95% [1.015; 1.056], p&lt;0.001). Table 1. Demographic, clinical characteristics and Ultrasound results of patients and controls. Characteristic RA casesn=200 Healthy controlsn=111 Age - years 62.05 (10.75) 58.3 (12.14) Female sex – number (%) 163 (81.5) 73 (65.77) BMI – value (ds) 26.38 (5.03) 26.2 (5.19) Smoking habit Never Smoked 107 (53.5%) 71 (63.96%) Ex-smoker 51 (25.5%) 20 (18.02%) Active smoker 42 (21%) 20 (18.2%) Race – number (%) Caucasian 186 (93) 62 (93.94) Comorbidities – number (%) High blood pressure 83 (41.5%) 34 (30.63%) Dyslipemia 93 (46.5%) 39 (35.14%) Blood pressure -- mmHg 127.2(18.36)/78.67(10.21) 127.77(19.42)/78.28 (10.59) Ultrasound findings Right carotid cIMT 0.78 (0.15) 0.62 (0.11) Left carotid cIMT 0.77 (0.14) 0.64 (0.12) Plaques 101 (50.5%) 32 (28.83%) Bilateral 64 (32%) 11 (9.91%) Right carotid 17 (8.5%) 7 (6.31%) Left carotid 20 (10%) 14 (12.61%) Eight patients (4%) presented a cardiovascular event, and one of them died (0.5%). The events consisted in 2 angina pectoris, 3 transient ischemic attack, 1 acute myocardial infarction, 1 lacunar stroke and 1 cardiac arrest. Six out those 8 patients demonstrated bilateral plaque presence at baseline. Two patient caused loss of follow up due to death related to Covid-19. Not a single cardiovascular event was reported in the control group. Conclusion Our results shows that cardiovascular events are increased in RA patients and US study may be useful in predicting an event. Disclosure of Interests None declared